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The United States is experiencing an unprecedented number of active drug shortages. This was reported by the American Society of Health-System Pharmacists and the University of Utah Drug Information Service. Despite changes in shortage levels over the past decade, the trend has been steadily increasing since 2021. It reached a record-high of 323 drugs in the first quarter of 2024. The last time active drug shortages were this high was back in 2014.
Affected Drugs
The shortages affect a wide range of drug classes. Generic sterile injectable medications, including cancer chemotherapy drugs and emergency medications, are among the most concerning. Other categories experiencing shortages include central nervous system stimulants, antimicrobials, hormone agents, and intravenous fluids.
These shortages have significant implications for patient care! This is most evident in the challenges faced by clinicians and patients. The average duration of a drug shortage is about a year and a half, with more than half of the shortages lasting over two years. Moreover, each shortage impacts at least half a million patients, particularly older adults.
Cause of Shortages
While increased demand can contribute to shortages, there are often other primary causes. These include manufacturing and quality issues, such as supply chain gaps and discontinuations. The FDA in particular has been criticized for falling behind on inspections. International facilities represent more than half of the manufacturers that supply the US, and have historically been a blindspot for the FDA. Effective inspections are:
...absolutely essential for ensuring the quality and the safety of the medicines that US citizens consume.”
Anthony Sardella, chair of the API Innovation Center
Efforts to address the crisis include collaboration with manufacturers and hospitals. This will enhance transparency in the drug market and incentivize investment in resilient supply chains.
However, there are concerns about proposed policy solutions. Financial penalties for hospitals lacking resources to comply with recommendations in particular could cause more problems than they solve. More comprehensive efforts are needed at the federal level to address the root causes of drug shortages and ensure sustainable solutions.
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